Purpose or Case Report: Imaging evaluation of the pediatric breast is often necessary to evaluate suspected disease in immature and developing mammary tissue. The initial assessment of these patients commonly occurs at a children’s hospital. In this retrospective study, we aim to demonstrate the landscape of pediatric breast imaging by providing the prevalence of various breast-related imaging techniques, diagnoses, and demographics encountered at an academic children’s hospital over a 10 year period.
Methods & Materials: The imaging database at a single academic children’s hospital was queried for all reports containing “breast” over 10 consecutive years (11/1/06-11/1/16). Each imaging report and electronic medical records were reviewed for demographics, clinical data, imaging findings, follow-up information, and histopathology when available.
Results: 1348 reports (595 inpatient, 124 ER, and 92 outpatient; 1129 ultrasound, 129 CT, and 90 MRI) from 1175 patients (1140 female, 208 male; mean 12 +/-6 years) were identified. The most common diagnoses were infection (abscess, cellulitis, mastitis) (n=244 patients), fibroadenoma (n=231 patients), gynecomastia (n=80 patients), breast buds (n=51 patients), ductal ectasia (n=30 patients), and hematoma (n=27 patients). Neoplastic disease was questioned in 16 patients; histopathology revealed 5 fibroadenomas, 1 hyperplastic lymph node, and 1 lipoma. The remaining 9 patients were either lost to follow-up (n=6) or considered to have benign disease after breast surgery consultation (n=3). There were no proven cases of breast carcinoma, sarcoma, or lymphoma.
Conclusions: Pediatric breast imaging encompasses an array of typically benign etiologies.
Breast disease in the pediatric population is generally benign; we found no proven cases of neoplastic breast disease in an academic children’s hospital setting over 10 consecutive years.